| Title: |
P-2129. Prolonged infusion of β-lactams for Enterobacterales bacteremia in high-risk neutropenic patients: Does it improve outcomes? |
| Authors: |
Herrera, Fabián; Torres, Diego; Tula, Lucas; Mañez, Noelia; Pereyra, María Laura; Berruezo, Lorena; Benso, José; Laborde, Ana; Suchowiercha, Nadia; Nenna, Andrea; Camelo, Jorge López; Gago, Rocío; Fernández, Nadia Ailen; Fernández, Verónica; Ibañez, María Luz González; Rossi, Inés Roccia; Soto, Vanesa; Grippo, Natalín; Blanco, Miriam; Visús, Mariángeles; Azula, Natalia; Carbone, Ruth; Pennini, Magdalena; Reynaldi, Mariana; Chaves, María Laura; Pasteran, Fernando; Corso, Alejandra; Rapoport, Melina; Carena, Alberto |
| Source: |
Open Forum Infectious Diseases ; volume 13, issue Supplement_1 ; ISSN 2328-8957 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2026 |
| Description: |
Background No evidences have been reported on the clinical benefits of prolonged infusion (PI) of β-lactams in febrile neutropenic patients (FNP) with Enterobacterales bacteremia (EB). Methods A prospective observational multicenter study was conducted in 9 referral academic centers in Argentina between February 2019 and December 2024. The first episodes of EB in high-risk FNP who received appropriate empirical treatment (AET) with piperacillin-tazobactam (PT), cefepime (C), or meropenem (M) were included. Clinical, epidemiological, and outcome variables were compared in patients receiving either standard infusion (SI) or PI AET. A propensity score (PS) to balance baseline covariates was used. Adjusted conditional multivariate logistic regression analysis to PS was used to identify independent risk factors for 30-day mortality. Results 201 patients were included (116 SI and 85 PI). Median age was 49 years (IQR: 35-63), and the most common underlying diseases were acute leukemia (61.69%) and lymphoma (18.91%). The microorganisms most frequently observed in both groups were E. coli (58.71%) and Klebsiella spp. (32.84%). Bacteremia presented with a clinical source in 58.82% of PI cases vs. 55.17% of SI cases, p = 0.60. Hypotension and shock were present in PI vs. SI in 28.4% vs. 25%, p=0.60, and 17.65% vs. 14.66%, p=0.56, respectively. Intensive care unit admission and multiorgan failure occurred in PI vs. SI: 18.82% vs. 12.07%, p = 0.56, and 16.47% vs. 11.21%, p = 0.28, respectively. Seven-day clinical response between IP and IB was 90.59% vs. 93.10%, p = 0.51. Thirty-day overall mortality and EB-related mortality were 14.12% vs. 10.34% (p = 0.41) and 8.24% vs. 3.45% (p = 0.20) for PI and SI, respectively. Septic shock was the risk factor associated with 30-day mortality (OR: 11.65, 95% CI, 3.66-36.91, p < 0.001), while 7-day clinical response was a protective factor for survival (OR: 0.06, 95% CI, 0.01-0.24, p < 0.001). PI did not correlate with impact on mortality (OR: 1.78, 95% CI: ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ofid/ofaf695.2293 |
| Availability: |
https://doi.org/10.1093/ofid/ofaf695.2293; https://academic.oup.com/ofid/article-pdf/13/Supplement_1/ofaf695.2293/66356615/ofaf695.2293.pdf |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.9C687CF4 |
| Database: |
BASE |